The rehabilitation team consists of the patient, his or her family and/or caregivers, a physical medicine and rehabilitation physician, therapists, rehabilitation nursing and other rehabilitation personnel who, by virtue of their education, training, and experience, are qualified to work with the patient and their family.
Scope of Services:
Admission Criteria
Every potential patient who may benefit from our care is discussed by the program director and consultant physician. The rehabilitation potential for every patient is evaluated prior to admission.
Admission Criteria for all inpatient programs includes the following:
- Patients aged 14 years old and above are admitted upon assessment by the Rehabilitation Physician based on their condition and rehabilitation potential.
- The patient is expected to achieve significant improvement over a specified period according to the doctor.
- Patients with functional loss as a result of an Acute Stroke, SCI, TBI and other acute/recent onset neurological conditions requiring active rehabilitation.
- Patients should be medically stable and have adequate abilities in order to participate and cooperate in both active and slow stream interdisciplinary rehabilitation program.
- Patient should be able to tolerate the level of physical activity that is required in active rehabilitation program (up to 3 hours a day, 5 days a week for at least 2 different types of therapy).
- Patient requires a 24-hour supervision of a physician with special training or experience in the field of rehabilitation.
- Patient requires a 24-hour availability of a registered nurse with specialized training or experience in rehabilitation.
- There is a clear discharge plan agreed with the patient, family and/or significant other(s).
Rehabilitation Program
The amount of therapy provided, the number of disciplines involved as well as the amount of time per discipline, is individualized for each patient based on their needs and functional level.
The rehabilitation program is initiated on the day of admission and the therapy day can typically begin around 8:00 a.m. and ends about 5:00 p.m. The total time in therapy may vary on different days reflective of each patient’s tolerance and needs, but overall patients will receive at least three hours of therapy 5-6 days/ week.
Sessions are typically 30-60 minutes, 1-2x per day. Patient tolerance, preferences and fatigue are always considered when schedules are made. The rehabilitation therapy extends beyond the individual sessions throughout the entire 24 hours when the Rehabilitation Nursing staff reinforces the therapeutic techniques during daily activities.
In-Patient Rehabilitation Team Description
The philosophy of the inpatient programs is that the program’s mission can best be accomplished by providing rehabilitative care through a multidisciplinary team approach.
The team consists of the following:
- The patient
- Patient’s family and/or caregiver(s)
- Physical Medicine and Rehabilitation Physician
- Rehabilitation Nursing
- Neuropsychology
- Speech and Language Therapy
- Occupational Therapy
- Physical Therapy
- Case Management
- Social Services
- Dietetics & Nutrition
Additional services available to meet the needs of each individual patient include:
- Medical consultations (Psychiatry, Podiatry, Urology, Plastics, ENT, Dermatology, etc.)
- Respiratory therapy
- Spiritual Services
- Orthotic/Prosthetic Services
- Hydrotherapy
- Gait Lab
- Easy Street
- Pharmacy
- Radiology
- Laboratory Services
- Seating & Mobility Services (Wheelchair, positioning devices)
Length of Program: The duration of your rehabilitation depends on the severity of your condition and related complications. Your rehabilitation plan will change during your recovery as you relearn skills and your needs change. With ongoing practice, you can continue to make gains over time.
Discharge Criteria
The discharge planning process begins when the patient is first admitted to the program. The case manager facilitates the discharge planning process, coordinating information from all members of the interdisciplinary team, the patient, and the caregivers/family. Based on the individual’s functional status, family support, pre-morbid living situation and level of function, and available resources the team makes recommendations for the most appropriate and suitable discharge plan for the patient.
At the team or family’s request, a formal meeting with the team and patient/family is scheduled to discuss appropriate options. A safe discharge is a primary consideration when options are considered.
Patients are discharged from the inpatient rehabilitation programs when any of the following occur:
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Patient who has achieved the inpatient rehabilitation goals are discharged with clear plan explained to the patient/caregiver/family.
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Patient who has remained in plateau situation and has not achieved the goal of the rehabilitation program.
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Patient is unwilling to actively participate in the inpatient rehabilitation program.
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Patient requesting discharge against medical advice.
Transfer Criteria to other HMC hospitals
- Patients who develop urgent or unstable medical conditions that require further investigation and treatment, will be transferred to the Emergency Department in Hamad General Hospital or ACC-ICU based on clinical assessment.
- Patients undergoing rehabilitation programs who require acute medical follow up and management are transferred to Acute Care Units in HMC.
- Patients who have not made significant progress after a twelve (12) weeks rehabilitation program or patients have reached the limit of their recovery. If such patients are unable to live at home and require skilled nursing care and supportive rehabilitation therapies they may be transferred to Long Term Care / Specialized care center/ Residential services as appropriate.
- Patients above 65 years of age who have completed the full rehabilitation program but are unable to be discharged home may be transferred to a Long-Term Care / Specialized care center/ Residential services as appropriate.
